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Biomedical subjects

F Greif

Publications and source records attributed to F Greif.

29 records · Page 2Linked to original sources

Proximal colostomy: still an effective emergency measure in obstructing carcinoma of the large bowel.

Large bowel obstruction constitutes an emergency abdominal condition and necessitates prompt surgical treatment. The optimal approach is still controversial as to whether to perform a diverting colostomy only or a tumor resection with or without primary anastomosis. Seventy-one elderly and high-risk patients were treated by proximal diverting colostomy through a right upper abdominal incision. The operative mortality was 8.5%, with an additional morbidity of 20.5%. Stomal complications appeared in 6.1% of the survivors. Seventy-five percent of surviving patients underwent successful resection and closure of colostomy within 3 months without additional mortality. Others were not operated because of metastatic disease or severe concomitant disease. We conclude that although primary resection should be attempted in good risk patients, for those patients who are elderly and at high risk, a simple life-saving procedure, such as fecal diversion, could alleviate obstructions with relatively low morbidity and mortality and improve the patient's prospects for subsequent definitive surgery.

Aged↗

Burkitt's lymphoma protruding through the anus. Report of an unusual case.

A four-year-old boy had a cecoanal intussusception prolapsing through the anus. A 4 x 4 cm cecal tumor served as the leading point of the intussusception. Laparotomy and histology revealed that the tumor was a solitary Burkitt's lymphoma of the cecum. Isolated Burkitt's lymphoma, as presented here, is rare, and such a combination has never been reported. Intussusception prolapsing through the anus and Burkitt's lymphoma are discussed, as well as a possible reason for the rarity of the condition.

Burkitt Lymphoma↗

The effect of growth-promoting agents on replication and cell cycle withdrawal in cultures of epidermal keratinocytes.

Epidermal keratinocytes grow in culture to form a stratified squamous epithelium. These cultures contain a replicating as well as a terminally differentiating population and undergo surface desquamation. Epidermal growth factor (EGF) and cholera toxin are usually employed as growth-promoting agents because they reduce the population doubling time; that is, the period required to increase the total cell number twofold. There are three ways in which this reduction in population doubling time could be achieved: (a) the time for one cell cycle or the cell cycle length may be shortened; (b) the number of cells that withdraw from the cell cycle and terminally differentiate may be reduced; or (c) the number of cells that desquamate into the medium over a set period of time may be reduced. We have explored these possibilities in growing cultures of epidermal keratinocytes using a newly developed double-label assay. This assay gives a measure of both cell length and cell cycle withdrawal. Results show that the growth enhancement induced by EGF and cholera toxin can be attributed primarily to a reduction in cell cycle withdrawal and, to a lesser degree, to a reduction in cell cycle length. EGF and cholera toxin have no significant effect on the rate of desquamation. A linear correlation was noted between cell cycle lengths and withdrawal, suggesting an interconnection between the rate of cell renewal and the likelihood of undergoing terminal differentiation.

Cell Cycle↗

Rectoscopic decompression of acute recto-sigmoid obstruction.

Effective non-operative decompression of a low obstruction of the colon can sometimes be accomplished by inserting a tube into the rectum and threading the tip up to a point proximal to the obstruction (1). Failure of this non-surgical decompression would require emergency surgery--either a diverting colostomy or a two-stage resection. A new non-surgical treatment performed on a patient with an obstructive tumor of the recto-sigmoid is described. Decompression of the obstructed bowel was achieved with a rectal tube introduced over a flexible guide wire proximal to the obstruction with the aid of a rectoscope, following which a one-stage procedure--an anterior resection was performed in one patient, while the other was referred for oncological treatment.

Acute Disease↗

Cell-cycle withdrawal in cultured keratinocytes.

Cell-cycle withdrawal is the irreversible arrest of replication that occurs in keratinocytes early in terminal differentiation. According to the epidermal proliferation unit (EPU) model of renewal, withdrawal takes place in a subset of cells that have completed a final cycle of amplification replication. Using a recently developed double-labelling assay, we followed cell-cycle withdrawal in growing cultures of epidermal keratinocytes and correlated these results with population-growth kinetics. The levels of withdrawal measured were much too high to be consistent with the population-growth kinetics. These unexpectedly high levels could be explained by postulating that withdrawal takes place in a specific subset of cells, as described by the EPU model. Other possible explanations were entertained but, for various reasons, were considered unlikely. To learn whether withdrawal occurred in basal or suprabasal cells, confluent cultures were pulse labeled with 3H-thymidine, and the position of the labeled cells was monitored by autoradiography during the period of cold chase. The results indicated that, in cultured keratinocytes, withdrawal takes place while the cells are still in the basal compartment.

Bromodeoxyuridine↗

Tumor differentiation and histological type in human breast cancer.

Biopsies from 61 women with breast cancer were assessed for various histological features. These results were statistically analyzed for associations of gross tumor size, patient age, stage of disease, tumor hormone receptor status, with accepted systems of nuclear and histological grading for differentiation. Tumors with highly differentiated grading had smaller cell nuclei, stromal elastasis, intraduct carcinoma and tubular formations. Poorly differentiated tumors had large vesicular cell nuclei and increased mitotic indices. Gross tumor size was also linked with stromal elastosis, intraduct carcinoma, a specific pattern of stromal infiltration, and mitotic index. No relationship could be found between any of the above features and the patients clinical statuses or their tumors' hormone receptivities. The existence of two distinct histological patterns of breast carcinoma is proposed; the patterns may either represent stages in the development of the tumor or different biological types.

Breast Neoplasms↗

Acid ingestion: another cause of disseminated intravascular coagulopathy.

This report presents a case of disseminated intravascular coagulopathy developing within 2 h after ingestion of 96% (glacial) acetic acid in an attempted suicide. Although bleeding from the GI tract is found commonly in acid injury, this case illustrates that it may also be an early manifestation of disseminated intravascular coagulopathy.

Acetates↗

A correlation between oestrogen receptors and tumour size in primary breast cancer.

Oestrogen receptor (OR) assay has an essential role in selecting therapy for breast cancer patients, OR status is probably also of prognostic value. The correlation between the size of the primary tumour and OR status was evaluated in 100 women with breast cancer. In 72 post-menopausal patients the OR average level was significantly higher in large primary tumours--T2, T3, when compared to OR levels of T1 tumours. In the 28 pre-menopausal women, this difference was not statistically significant. No correlation between OR level and stage of disease was found. Women presenting with large primary tumours do not necessarily have a poor prognosis.

Adult↗

Use of a collagen-based device for closure of low brachial artery punctures.

PURPOSE: To report our experience with the Angioseal vascular closure device for hemostasis of distal brachial artery puncture. METHODS: Between September 2003 and August 2005, 64 Angioseal vascular closure devices were inserted in 64 patients (40 men, 24 women; mean age 65 years) immediately after diagnostic or therapeutic arterial angiographies performed through a 5 Fr to 7 Fr sheath via the distal brachial artery. Ultrasound examination of the brachial artery preceded the angiography in all cases and only arteries wider than 4 mm were closed by the Angioseal. In cases of a sonographically evident thin subcutaneous space of the cubital fossa, tissue tumescence, using 1% Lidocaine, was performed prior to the arterial closure. RESULTS: The deployment success rate was 100%. No major complications were encountered; only 2 patients developed puncture site hematoma, and these were followed conservatively. CONCLUSIONS: Closure of low brachial artery punctures with the Angioseal is simple and safe. No additional manual compression is required. We recommend its use after brachial artery access interventions, through appropriately wide arteries, to improve early patient ambulation and potentially reduce possible puncture site complications.

Adult↗